Tec-NQ Short Course Application

SHORT COURSE APPLICATION FORM

If you want to know more about Tec-NQ, please call us on 1300 665 733 or (07) 4779 2199 during business hours. Thank you for your interest at Tec-NQ and we look forward to meeting you soon!

Section 1 - Select a Course
Select a Course	There are currently no courses available
Please read our Standard Collection Notice regarding the collection and storage of personal information	I confirm that I have read and accept the Standard Collection Notice
Please read our Image Release Form regarding permission for Tec-NQ to use images of the participant in promotional materials	Yes No

Please provide 3 forms of identification
The evidence of identity document must comprise either: • One Category A document and two Category B documents, or • Two Category A documents and one Category B document. See worksafe.qld.gov.au > evidence-of-identity for a list of documents in Category A and B.
Category A
Category A or B
Category B
Please provide a copy of your trade certificate
Trade Certificate
Section 2 - Participant Details
USI (Unique Student Identifier), if you do not currently have a USI please create one here www.usi.gov.au
First Name
Last Name
Gender
Date of Birth
Phone Number
Email Address
Address (street # and name)
Suburb/City
State
Postcode
Section 3 - Emergency Contact
Contact Name
Phone Number
Section 4 - Training Profile
Residency Status
Country of Birth
Are you of Aboriginal or Torres Strait Islander origin?
Language spoken at home
How well do you speak English?
How would you rate you literacy and numeracy?	High Average Low
Are you still attending school?	Yes No
What is your highest COMPLETED school grade?
In what year did you complete that school grade?
Which of the following best describes your employment status?
Which of the following best describes your reason for undertaking this course?
Have you Successfully completed any of the following qualifications?
If yes, please provide details:
Section 5 - Medical Information
Do you have a disability, impairment or long term medical condition?
If yes, please provide details:
Do you have any allergies	Yes No
If yes, please provide details:
Please confirm and hit Submit

SHORT COURSE APPLICATION FORM

Section 1 - Select a Course

Please provide 3 forms of identification

Please provide a copy of your trade certificate

Section 2 - Participant Details

Section 3 - Emergency Contact

Section 4 - Training Profile

Section 5 - Medical Information